Should you prescribe generics instead of brand name drugs?

Do you ever wonder if, as a doctor, you are prescribing generic medications often enough? Regardless of the frequency with which you do – if you do –, the American College of Physicians thinks you could pick up the pace a bit. “While the use of generic drugs has increased over time, clinicians often prescribe more expensive brand-name drugs when equally effective, well proven and less expensive generic versions are available,” College president Wayne J. Riley said. Generic medications represent 88% of prescriptions in the U.S.A. but only a third of the $325+ billion Americans spend on prescription medications every year.

It is worth clarifying that, in many occasions, this expenditure is self-chosen. Some physicians report prescribing brand name drugs at their patients’ request. “The likelihood of this behavior was significantly higher for physicians who also reported that they received industry-provided food and samples or who met with [brand name] representatives,” researchers wrote in a paper published in the journal of the American College of Physicians, Annals of Internal Medicine. One of the reasons that patients request brand name medications is that they are under the wrongful impression that the lower price of generics is a reflection of their quality – or lack thereof –; a belief that is even shared by some doctors. But cheap does not necessarily mean shoddy. Take for instance cheap medical supplies at Discount Medical Supplies, where low prices and high quality are not mutually exclusive.

The same goes for generic drugs. As Dr. Kevin Campbell writes on, generics are not only “always cheaper than brand-name medications” but “in other words, their pharmacological effects are exactly the same as those of their brand-name counterparts. The U.S. Food and Drug Administration (FDA) require that generic drugs be as safe and effective as brand-name drugs.” So similar in anything but price are generic and brand name drugs that – the report found – many doctors still refer to them by their original brand name even after generic versions have entered the market, leading to the inadvertent prescribing of costlier drugs.

As a result, billions of dollars are needlessly spent. By way of example, the authors of the study cited a study of Medicare beneficiaries with diabetes, in which 23%-45% of prescriptions – depending on drug class – were for brand name medications for which they were generic versions available. According to the researchers, relying on generic drugs whenever feasible would not only save money but also increase patients’ adherence. “Prescriptions for brand-name medications are almost twice as likely as those for generic therapies to be 'abandoned' (that is, never picked up after being filled),” they wrote. “Thus, greater use of generic drugs could result in long-term adherence to essential therapies.” This view is supported by CDC research which suggests that “reducing out-of-pocket costs (ROPC) to patients may improve medication adherence and consequently improve health outcomes.”

Related: How much do brand name drug prescriptions cost taxpayers?